I’ve been traveling late this week –and there was a copy of USA Today waiting outside my door this morning. Today’s business section has a front page article (penned by the nonprofit journalism group Propublica) on the influence of medical device companies on medical specialty societies.

The article focuses on the Heart Rhythm Society, which is having its 2011 convention in San Francisco this week.The HRS has about 5000 cardiologists and others – and they implant $6.7 billion of automatic debrillators each year (domestic and international sales).

HRS gets half of its $16 million annual budget from selling “promotional opportunities” to big medical device companies at this annual meeting. The promotional opportunities include advertising on hotel keys, nightstand displays, mobile sidewalk billboards and “promotional booths the size of mansions.” The majority of directors of HRS get fees from medical device companies as well.

Jack Lewin, the chief executive of the AmericanCollege of Cardiology, is quoted as saying that the advertising doesn’t influence cardiologists’ decision to implant devices or choice of devices.The direct quote:"I don't buy a soft drink just because of the advertising. … I buy it because I like it."

Don’t believe this for a minute.Advertising unequivocally works. Very smart companies wouldn’t spend billions of dollars if advertising wasn’t effective.

The vast quantities of bling at specialist conventions is a real concern.Marketing is critical to companies to differentiate their products, and the attention that medical device companies purchase leads to higher use of their products.

Part of the problem is that physicians, like everyone else, like things that are free.Medical journals would cost far more were it not for the pharmaceutical advertisements, and national conferences like the soiree in San Francisco this week would be prohibitively expensive to attend were it not for commercial sponsorships.Frankly, these conferences would be less fun without the bling –so fewer physicians would attend.

Some specialty societies have had internecine conflict over the issue of commercialization, and USA Today quotes a former president of the American Society of Hypertension (ASH), who resigned from ASH over this issue and calls sponsorships an “obscenity.” .

What should we do that would not impede the important commercial speech of the pharmas and the medical device companies, yet better protect the public and medicine’s professionalism?

I favor dramatic expansion of transparency.

Nonprofit physician specialty societies should open to the public the full range of all financial dealings with suppliers of medical goods and services.Reporting of honoraria and other inducements to practicing physicians and researchers should be expanded.All reports should be available to the public in formats that allow downloading and data mining – we see how valuable this has been in Minnesota and elsewhere. Charles Grassley has been working to gain access to this information – and this effort deserves our support.